The paper takes a look at insurance customer dishonesty as a special case of consumer ethics, understood as a way of situation handling, as a moral choice between right and wrong, such as between self-interest vs. common-interest, in other words, a “moral temptation”. After briefly raising the question if different schools, of moral philosophy would conceptualize such moral temptations differently, the paper presents ‘moral psychology’ as a frame of reference, with a focus on cognitive moral development, moral (...) attitude and moral neutralization. Conceptualization questions can’t be answered finally without thinking at the same time of empirical research design and instrument design decisions, e.g. choosing between experiment vs. questionnaire studies, designing suitable moral temptation situations as an experiment vs. questionnaires with scenario vignettes. The paper discusses then experiences from a 2004 pilot survey, with a main focus on a few insurance dishonesty scenarios with follow-up questions. The paper has an open end, i.e. outlines desirable future theoretical, empirical and practical work with insurance customer dishonesty. (shrink)

Most consumer morality studies focus on consumer immorality, i.e. different types and degrees of consumer dishonesty or deviance. This paper follows this tradition, by looking at insurance customer dishonesty. For looking at insurance customer dishonesty in a wider perspective, the paper drafts a sociology of insurance customer morality, including outlines of micro-level, meso-level and macro-level moral sociologies of insurance fraud, as well as a discussion of moral heterogeneity and a critical understanding of deviance. (...) As a next step a few empirical rsearch questions are formulated and illustrated with data from a Norwegian-German pilot study. (shrink)

Current research on the human genome holds enormous long-term promise for improvements in health care, but it poses an immediate ethical challenge in the area of health insurance, by raising the question of whether insurers should be allowed to take genetic information about customers into account in the setting of premiums. It is widely held that such discrimination is immoral and ought to be illegal, and the prevalence of this view is understandable, given the widespread belief, which I endorse, (...) that every individual in a society as affluent as ours has a basic right to affordable health care. But prohibiting genetic discrimination in health insurance is not an effective way to protect this right. On the contrary, I argue that because of the nature of insurance as a product sold in a competitive market, such a prohibition is misguided, and its worthy aims must, instead, be pursued through reforms in our country’s system of publicly provided health care. (shrink)

:This article examines privacy threats arising from the use of data mining by private Australian health insurance companies. Qualitative interviews were conducted with key experts, and Australian governmental and nongovernmental websites relevant to private health insurance were searched. Using Rationale, a critical thinking tool, the themes and considerations elicited through this empirical approach were developed into an argument about the use of data mining by private health insurance companies. The argument is followed by an ethical analysis guided (...) by classical philosophical theories—utilitarianism, Mill’s harm principle, Kant’s deontological theory, and Helen Nissenbaum’s contextual integrity framework. Both the argument and the ethical analysis find the use of data mining by private health insurance companies in Australia to be unethical. Although private health insurance companies in Australia cannot use data mining for risk rating to cherry-pick customers and cannot use customers’ personal information for unintended purposes, this article nonetheless concludes that the secondary use of customers’ personal information and the absence of customers’ consent still suggest that the use of data mining by private health insurance companies is wrong. (shrink)

This paper seeks to explore the implementation of corporate ethical culture and policies as an adjunct to formal forms of corporate governance. The insurance industry utilises a variety of external governance structures, but is almost unique in that stock companies (which are exposed to an external market for corporate control) and mutual companies (which are owned by a subset of their customers) are in active competition. A questionnaire survey of senior executives in U.K. insurance companies was undertaken to (...) explore the implementation of ethical policies and codes, to investigate ethical attitudes, and to analyze the extent to which these policies and attitudes varied among companies. The results suggest that ethical policies have a higher profile and ethical attitudes and behaviour are more positive in mutual as opposed to stock insurance companies. These findings support the contention that a strong corporate ethical culture may be utilised to enhance formal corporate governance instruments. (shrink)

This study examines the relationship between the ethical behavior and customer orientation of insurance sales agents engaged in the selling of complex services, e.g. health, life, auto, and property insurance. The effect of ethical and customer-oriented behavior, measured by the SOCO scale (Saxe and Weitz, 1982), on the annual premiums generated by the agents is also investigated. Customeroriented sales agents are found to engage in less unethical behavior than their sales-oriented counterparts. Further, sales-oriented agents are found (...) to perceive greater levels of unethical behavior among their significant others. Alarmingly, higher levels of sales premiums are found among those agents who engage in unethical behavior. (shrink)

In recent years, insurance companies have begun tracking their customers’ behaviors and price premiums accordingly. Based on the Market-Failures Approach as well as the Justice-Failures Approach, I provide an ethical analysis of the use of tracking technologies in the insurance industry. I focus on the use of telematics in car insurance and on the use of fitness tracking in life insurance. The use of tracking has some important benefits to policyholders and insurers alike: it reduces moral (...) hazard and fraud, increases actuarial fairness, and incentivizes safe behavior. These benefits, however, are outweighed by significant moral objections. First, the use of tracking technologies significantly undermines the fairness of the interaction between insurance companies and policyholders. Specifically, the use of tracking eliminates information asymmetries, but in such a way that favors insurers exclusively. Furthermore, tracked behaviors and the ability to choose to behave safely are highly correlated with other variables such as income. Therefore, tracking-based insurance relies on and exacerbates existing inequalities and injustices, which undermines the benefits that tracking is supposed to introduce. (shrink)

The insurance industry’s practice of producing comprehensive insurance policies can have unforeseen and negative ethical consequences. Insurance policies express promises from the insurer to the insured, to the effect that the insurer should be trusted to appropriately assist the insured in case of accident. The relation is seriously undermined when the content of the promise is blurred, containing clauses and condition which are ambiguous or hidden in fine print. This paper contains an investigation of (1) the sources (...) of the fine print policy practice, (2) its immediate effects on the degree to which the policies are understandable to the insured, (3) the ethical consequences that can follow from blurring the true content of the insurer’s promise to the insured and (4) the measures insurers can take in order to develop a more constructive ethical relationship with its customers. (shrink)

Although a number of articles have addressed ethical perceptions and behaviors, few studies have examined ethics across cultures. This research focuses on measuring the job satisfaction, customer orientation, ethics, and ethical training of automotive salespersons in the U.S. and Taiwan. The relationships of these variables to salesperson performance were also investigated. Ethics training was found to be negatively related to perceived levels of ethicalness and performance. High performance U.S. salespeople reported high ethical behavior, while the opposite (...) was true in Taiwan. Customer orientation in both countries was influenced by ethics training. Managers should evaluate current ethics training programs to insure correct ethical behavior is taught and rewarded. (shrink)

Increasing frauds in insurance and mortgage‐lending illustrate the dilemma for companies between tackling fraud in the public interest and retaining customer confidence and competitive position.

Arguments against the possible use of genetic test results in private health and life insurance predominantly refer to the problem of certain gene carriers failing to obtain affordable insurance cover. However, some moral intuitions speaking against this practice seem to be more fundamental than mere concerns about adverse distributional effects. In their perspective, the central ethical problem is not that some people might fail to get insurance cover because of their ‘bad genes’, but rather that some people (...) would manage to get insurance cover because of their ‘good genes’. This paper tries to highlight the ethical background of these intuitions. Their guiding idea appears to be that, by pointing to his favourable test results, a customer might make an attempt to ‘sell his body’. The rationale of this concept is developed and its applicability to the case at issue is critically investigated. The aim is to clarify an essential objection against the use of genetic information in private insurance which has not yet been openly addressed in the academic debate of the topic. (shrink)

National attention on issues of public health preparedness necessarily brings into sharp focus the question of how to assure adequate, community-wide health care financing for preventive, acute care, and long-term medical care responses to public health threats. In the U.S., public and private health insurance represents the principal means by which medical care is financed. Beyond the threshold challenge of the many persons without any, or a stable form of, coverage lie challenges related to the structure and characteristics of (...) health insurance itself, particularly the commercial industry and its newly emerging market of consumer-driven health plans. States vary significantly in how they approach the regulation of insurance and in their willingness to support various types of insurance markets. This variation is attributable to the size and robustness of the insurance market, the political environment, and regulatory tradition and custom. Reconciling health insurance markets with public health-related health care financing needs arising from public health threats should be viewed as a major dimension of national health reform. (shrink)

This study investigates the persuasive advertising and informative advertising effects of CSR initiatives on corporate reputation and brand equity based on the evidence from the life insurance industry in Taiwan. The study finds, first, policyholders’ perceptions concerning the CSR initiatives of life insurance companies have positive effects on customer satisfaction, corporate reputation, and brand equity. Second, the advertising effects of the CSR initiatives on corporate reputation are only informative. Third, the impacts of CSR initiatives on brand equity (...) include informative advertising and persuasive advertising effects. This study contributes the literature by explicit defining the advertising effects of CSR initiatives. Following the first step made by McWilliams et al. (Journal of Management Studies 43(1):1–18, 2006 ), the hypotheses of this study crystallize their conceptual framework. The obtained results in this research first identify the informative advertising effects and persuasive advertising effects of CSR initiatives. (shrink)

In an ever more transparent, digitalized, and connected environment, customers are increasingly pressuring brands to embrace genuine corporate social responsibility practices and co-creation activities. While both CSR and co-creation are social and collaborative processes, there is still little research examining whether CSR can boost co-creation. In addition, while previous research has mainly related co-creation to emotional outcomes, limited empirical research has related it to rational and behavioral outcomes. To address these shortcomings in the literature, this paper examines the influence of (...) CSR on customer loyalty, considering the mediating roles of co-creation and customer trust. It also investigates the influence of co-creation on customer trust. The data were collected in Spain in late 2017 using an online survey, and the sample contained 1101 customers of health insurance services brands. Structural equation modeling was used to test the hypothesized relationships simultaneously. The results show that CSR influences customer loyalty both directly and indirectly through co-creation and customer trust. However, the indirect impact is the stronger of the two, implying that embracing co-creation activities and developing customer trust can make it easier for CSR practices to enhance customer loyalty. In addition, co-creation has a direct effect on customer trust. (shrink)

Clients may feel trapped into sharing their private digital data with insurance companies to get a desired insurance product or premium. However, private insurance must collect some data to offer products and premiums appropriate to the client’s level of risk. This situation creates tension between the value of privacy and common insurance business practice. We argue for three main claims: first, coercion to share private data with insurers is pro tanto wrong because it violates the autonomous (...) choice of a privacy-valuing client. Second, we maintain that irrespective of being coerced, the choice of accepting digital surveillance by insurers makes it harder for the client to protect his or her autonomy. The violation of autonomy also makes coercing customers into digital surveillance pro tanto morally wrong. Third, having identified an economically plausible process involving no direct coercion by insurers, leading to the adoption of digital surveillance, we argue that such an outcome generates further threats against autonomy. This threat provides individuals with a pro tanto reason to prevent this process. We highlight the freedom dilemma faced by regulators who aim to prevent this outcome by constraining market freedoms and argue for the need for further moral and empirical research on this question. (shrink)

Purpose This paper explores and identifies customer-value-related sacrifices that consumers attach to interactive health/life insurance. This paper aims to increase understanding of why individual consumers are not willing to embrace behaviour-tracking-based insurance applications. Design/methodology/approach The authors analysed data from a qualitative survey of Finnish insurance consumers who were not keen on adopting interactive insurance products. Findings Developed through thematic analysis, the framework presented in this paper illustrates consumers’ value sacrifices on four dimensions: economic, functional, emotional (...) and symbolic value. Research limitations/implications The framework and insights emerging in the study hold several implications related to increased understanding of consumers’ perceptions of insurance and to developing interactive insurance services. In addition, this work provides a promising foundation and avenues for further considerations related to digital ethics in insurance. Originality/value To the best of the authors’ knowledge, this paper is the first piece applying a value sacrifice perspective in studying consumers’ unwillingness to adopt interactive insurance products. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Organizational Ethics and Health Care: Expanding Bioethics to the Institutional Arena **Laura Jane Bishop (bio), M. Nichelle Cherry (bio), and Martina Darragh* (bio)In 1995, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) expanded its patient rights standards to include requirements for assuring that hospital business practices would be ethical. Renamed “Patient Rights and Organization Ethics,” these standards are based on the realization that a hospital’s obligation (...) to its patients is derived from two relationships: the patient-provider relationship governed by “clinical ethics,” and the customer-supplier relationship governed by “business ethics.” “[This] boundary between ‘clinical’ ethics and ‘business’ ethics is not clear and in many cases is nonexistent. While marketing and admission practices are seen as issues related to ‘business’ ethics, they can lead to unneeded admissions or demand for unneeded services, both of which can unnecessarily expose the patient to the risk of side effects or complications. Likewise, underutilization of needed services is likely to lead to less than optimal health outcomes” (I. Schyve 1996, p. 17). “These new standards arose out of well-publicized concerns about abuses in which patients were admitted to hospitals unnecessarily and were discharged or transferred only after their insurance expired” (I. Schyve 1996, pp. 15–16).These abuses also sparked eloquent protests against threats to patient well-being and to the nature of the patient-provider relationship in the bioethics literature. The fiduciary responsibility of the provider to inform and to protect the patient was fragmented by insurer business practices such as gag clauses and economic credentialing of providers (VII. Scope Note 31, 1996). The background role that the institution plays, though poorly articulated historically, has been brought sharply into focus by the explosive growth of the managed practice of medicine. The context of medical ethics is no longer limited to the resolution of individual cases, but instead encompasses the adoption of institutional structures to protect and promote patient welfare (IV. Emanuel 1995, p. 335). In this new configuration, the institution and the providers are co-fiduciaries for populations [End Page 189] of patients, and the medicine that is practiced is “appropriately economically disciplined.” The expression “My patient always comes first” is no longer “... intellectually serious or morally responsible.” But, “... to be sure, both conceptually and in practice, being an economically disciplined fiduciary professional or institution is ethically unstable.... The task is to identify the boundaries outside of which institutional policy and behavior will not count as an ethically defensible form of being... [a] fiduciary.” (IV. McCullough 1997, pp. 143–44). This process of delimiting and enforcing boundaries requires the development of “... a language for talking about the ethical values of the organization. If such a language does not exist, discussions about ethics become cumbersome and unlikely to occur” (IV. Cleveland Clinic Foundation 1998, p. 2).As with bioethics generally, the literature addressing organizational ethics is multidisciplinary. JCAHO’s compliance guide for its revised standards, Ethical Issues and Patient Rights, draws on a wealth of ideas from both clinical ethics and business ethics. This is often an awkward alliance. “Because the study of organizational ethics is in its infancy compared to other areas of healthcare ethics, discussions about it often seem like hot air with no palpable payoff” (I. Boyle 1998, p. 2). The fact that “... there is an ancient history that reflects widespread doubt about the moral probity of business” (II. Frederick 1995, p. 209) does not help. To begin, “Aristotle had rude things to say about business” (II. Jackson 1998, p. 401). A brief review of introductions to several of the business ethics textbooks cited in this bibliography reveals that a rebuttal of “business ethics as an oxymoron” is the standard opening paragraph. This stigma is unfounded, and “increased stability” has characterized the state of business ethics literature during the 1990s (II. Beauchamp and Bowie 1997, p. ix). Significant attention has been given to elaborating two often overlapping theories—stakeholder and social contractarian.Originating in the 1960s as a pun on “stockholder,” proponents of stakeholder theory claim that a corporation’s fiduciary responsibility extends beyond increasing its profitability to protecting the rights of individuals or groups affected by its actions. Popular as a strategic planning tool in the... (shrink)

For-profit managed care organizations face decisions about cost sharing that can involve a tradeoff between the interests of investors and the interests of patients. No successful business can ignore the interests of its investors, but moral philosophy points to ethical reasons for managed care organizations to make patients’ health, rather than investors’ profit, their primary goal. One reason is the ethical obligation of all businesses to avoid wrongful exploitation of vulnerable customers. An insurance company’s cost-sharing policy can exploit customers (...) either by collecting an unfairly large amount of money from them or by unfairly deterring them from making claims for resources they medically need. Another reason stems from the fact that managed care organizations’ profits derive in part from the existence of artificial barriers to access to medicine, notably including patents. Putting a fence around a water well in the desert is legitimate only if doing so facilitates a financial arrangement that maximizes people’s access to water they need. Likewise, patents and other artificial barriers to access to medically necessary drugs are legitimate only if they are used to help finance access to medical resources people need. For these reasons, managed care organizations should make cost-sharing decisions that maximize the sustainable availability of effective drugs to patients who need them. (shrink)

KEY POINTS In Canada, commercial data brokers collect deidentified patient data from pharmacies, private drug insurers, the federal government and medical clinics without patient consent. Although pharmaceutical companies are the data brokers’ primary customers, academics and nonprofit and public entities also use commercial data sets, given the absence of a coordinated public approach to collecting these data across Canada. Risks of commercialized patient data include loss of anonymity, surveillance and marketing, discrimination and violation of Indigenous data sovereignty. Coordinated infrastructure for (...) the collection and coordination of health data across Canada and updated privacy legislation would protect individuals and communities and enable appropriate data uses. (shrink)

_GPs serve in a double role of treatment provider and expert in certain social insurance systems, such as the Norwegian one. Some physicians assert that the ethical obligations of the two roles conflict with each other. The objective of this article is to show that social insurance medical ethics, which are based on recognised principles of medical ethics, unite the physicians’ obligations associated with these roles. The method applied is a medical ethics conceptual analysis. The (...) material consists of literature on normative SIME. The study shows that SIME expands the role of the treatment provider to a wider societal context. Here, physicians should attempt to balance the perspectives of sympathy with empathy, as treatment providers, with the impartiality in their role as experts. Five principles of medical ethics are fundamental. Respect for human dignity is the overarching principle of medical ethics. The four others are nonmaleficence, beneficence, autonomy, and social justice. The article discusses two areas where it is asserted that the roles of treatment provider and expert conflict with each other: the application of beneficence and justice, and the duty of confidentiality versus the duty to provide information to the National Insurance service. The study concludes that there are no basic ethical conflicts between the two roles. The ethical problems that may arise when exercising this duality should be viewed in the same way as other ethical problems in medicine. Actual application and balancing of the principles may necessitate negotiations between patients and physicians. _ _Keywords_: dual roles, professionalism, deliberation, impartiality, medical principle ethics, values of welfare state. (shrink)

Digital transformation has allowed to offer additional services - which complement the main product - both in terms of use, emotional and relationship terms. Focused on a traditionally rational insurance customer offering a value that explores the customer's emotions, from co-creating with the user, allows brand differentiation. Given this idea, this document has three purposes. First, identify the role of expectations and the perceived quality of the customer's digital experience. Secondly, to identify the relationship between experience (...) and satisfaction gained in private insurance web areas. Third, identify the most valued digital attributes by the user. A sample of 4,178 customers registered was analyzed using the partial least squares technique. The model is highly predictive to customer experience and evidence the important relationship between the WOW effect and satisfaction, as well as the weak but doble role that expectations play on insurance digital self-service. The model demonstrates that expectations are only relevant before web consumption, because during the process it is the perceived digital quality, in particular the usefulness, information and technology, that offer a true customer experience. This article offers high academic value because it more accurately defines the determinants of the digital insurance customer experience and its effect on customer satisfaction in digital services. While expectations influence attitude before service, this research reveals that perceived digital quality is what delivers a true customer experience. Strategically, the implications are immediate in the field of business as it shows the importance of co-creation in digital design, not only because of the significant savings in implementation costs but also because it guarantees a greater experience, essential in the loyalty of its customers. This ensures the sustainable growth of the company. (shrink)

There is a move away from a market economy in health care in the United States and a move towards such a market in Germany.1 This article tries to make explicit what underlies the moral intuition that there is a tension between a market economy and health care. First, health care is analyzed in terms of the economic theory of the market and incompatibilities are described. The moral problem is identified as the danger of liquefying the distinction between persons and (...) things . The basic moral intuition seems to be the classical social contract: as a functioning market is governed by the principle of commutative justice , free riders have to be kept away, which is achieved by coercion that is not provided by the market; coercion can be justified by a social contract. The special moral problems of a social contract for health care are discussed. It is argued that public coercion in order to collect contributions for essential health care is justified. (shrink)

Definition of the problemFrom an ethical point of view we analyse the ruling of the German Federal Joint Committee (Gemeinsamer Bundesausschuss, G‑BA) of September 2019 to revise the guidelines about the coverage of noninvasive prenatal tests (NIPT) by mandatory health insurance, in order to include them under specified conditions. The decision contains four essential elements: a definition of the aim of NIPT testing (to avoid invasive testing), a criterion of access (test must be “necessary” for the pregnant woman to (...) tackle her individual situation), statements about the process of decision-making (after counselling by a physician and case by case) and a normative contextualization (termination of pregnancy under § 218 a German penal law) which is to be found in its explanations. There are tensions in the proposed model that oscillate about two axes: (1) The suffering that results from a possible birth of a child with trisomy or from not knowing about the genetic condition of the fetus can ultimately only be evaluated subjectively, from the perspective of the pregnant woman. (2) The meaning of an individual decision in the case-by-case model remains unclear because when judging about individual cases general points of view also need to be considered. However, we argue that the model of the G‑BA could be a sociopolitically and ultimately also ethically defensible pragmatic solution, exactly because of its paradoxes and its inherent flexibility. (shrink)

The expansion of competition on financial services market forces to search for new ways of development. A bank-insurance cooperation, which is more and more popular in the world and in Poland, becomes an effective remedy to this problem and a factor which stimulates rivalry and competition. The final beneficent of this cooperation is a customer for whom a diverse market offer of financial services means creation of added value. The customer’s satisfaction with that kind of services is (...) important to further development of bank-insurance cooperation. The aim of this work is to estimate whether the services of an integrated bank-insurance offer and insurances with mortgage credits are friendly and useful, and also whether they assure comfort and safety or may cause risk. (shrink)

A concise but informative overview of AI ethics and policy. -/- Artificial intelligence, or AI for short, has generated a staggering amount of hype in the past several years. Is it the game-changer it's been cracked up to be? If so, how is it changing the game? How is it likely to affect us as customers, tenants, aspiring homeowners, students, educators, patients, clients, prison inmates, members of ethnic and sexual minorities, and voters in liberal democracies? Authored by experts in (...) fields ranging from computer science and law to philosophy and cognitive science, this book offers a concise overview of moral, political, legal and economic implications of AI. It covers the basics of AI's latest permutation, machine learning, and considers issues such as transparency, bias, liability, privacy, and regulation. -/- Both business and government have integrated algorithmic decision support systems into their daily operations, and the book explores the implications for our lives as citizens. For example, do we take it on faith that a machine knows best in approving a patient's health insurance claim or a defendant's request for bail? What is the potential for manipulation by targeted political ads? How can the processes behind these technically sophisticated tools ever be transparent? The book discusses such issues as statistical definitions of fairness, legal and moral responsibility, the role of humans in machine learning decision systems, “nudging” algorithms and anonymized data, the effect of automation on the workplace, and AI as both regulatory tool and target. (shrink)

Insurance claim fraud costs insurance companies, policymakers, and taxpayers billions of dollars every year and has been described as the second largest white collar crime. The most common insurance fraud activity and one that contributes a significant portion of dollar losses is the practice of padding claim amounts in the event of a loss. One of the largest issues insurance companies face is that policyholders often do not perceive insurance claim padding as an unethical behavior. (...) However, very little research has examined the factors that contribute to such perceptions. Considering how consumers often attempt to justify fraudulent behavior from a fairness perspective, the present work examines how the amount of the deductible in an insurance claim situation can influence feelings of fairness and ethicality. The results of an experimental study show that higher deductible amounts result in stronger perceptions that insurance claim padding is fair to the insurance company, weaker perceptions that the behavior is unethical, and higher proposed claim award amounts. The study also shows, however, that the deductible amount effects are attenuated for consumers who display higher ethical standards as reflected by their scores on the consumer ethics scale. Implications are discussed with respect to the insurance industry, deviant consumer behavior, and general business ethics theory. (shrink)

ZusammenfassungVon Vertragsärzten in ihren Praxen angebotene oder hier von Patienten nachgefragte "individuelle Gesundheitsleistungen" sind in unserem Gesundheitswesen zu einer häufigen Erscheinung geworden. Es hat sich ein "zweiter Gesundheitsmarkt" mit einem erheblichen ökonomischen Potential entwickelt. Die Leistungen umfassen ein weites Spektrum; sie adressieren ganz unterschiedliche Gesundheitsstörungen, Ziele und Hoffnungen und sind extrem heterogen. Auch dies erschwert eine einheitliche Definition. Aus Patientensicht scheint das wichtigste Merkmal, dass IGeL vollständig privat bezahlt werden müssen. Der Beitrag diskutiert IGeL unter normativen Gesichtspunkten und adressiert 6 (...) Fragen: welche Risiken und Chancen beinhalten IGeL für das hergebrachte Bild des Arztes und seine Profession, das Verständnisder wissenschaftlichen Grundlagenärztlicher Untersuchungs- und Behandlungsmethoden, das Verständnis der Medizin und ihrer Ziele, die bisherige Rolle der Patienten, die Beziehung zwischen Arzt und Patient und das Bild der Gesetzlichen Krankenversicherung? Einerseits sind IGeL aus unterschiedlichen Gründen für Patienten und Vertragsärzte attraktiv. In Zeiten einer zunehmenden Regulierung der Medizin erhöhen sie Freiheitsgrade und Wahlmöglichkeiten beider Seiten. Andererseitshaben sie das Potential, vor allem die Rolleund Profession des ArztesimSystemderGKVund ihreWahrnehmungtiefgreifendzu verändern. Obsich der IGeL-Markt bei uns kontrollieren und regulieren lässt, ist eine zurzeit offene Frage. (shrink)

Microinsurance is the provision of insurance services to the poor, usually in developing countries. One of the key criteria of poverty is vulnerability even to minor events. In such cases, even micro coverage can make a major difference, yet still be funded by an affordable contribution by the insured. Like any kind of insurance, microinsurance can cover different risks to life, health, farming, property among other things. Our paper sketches how one could address and develop microinsurance business (...) class='Hi'>ethics. First, we introduce microinsurance to the business ethics community and business ethics to the microinsurance community. Our draft of microinsurance ethics is then developed from two angles: as a holistic understanding of ideals and possible ethical conflicts in key stakeholder relationships and by distinguishing eight challenges when targeting the poor and when marketing microinsurance. As an open ending, the article suggests a three-stage action research design focusing on how microinsurance could (and should) internalize ethics, respecting rather than neglecting national- and local-cultural conditions. (shrink)

Virtue ethics is regarded as the key in search of moral excellence among corporations. Yet, there are limited works to empirically investigate what virtuous character morally good corporations is expected to exhibit in the course of business from the perspective of customers. To fill this gap, we argue that customers are to evaluate firm’s virtuous character using Confucian cardinal virtues (ren, yi, and li) and perceived virtuousness determines customer loyalty. We test this argument using a sample of 276 (...) Hong Kong Chinese. The result suggests that a corporation not only has to offer a good value and high quality to customers but also needs to develop and acquire virtuous character in retaining customer loyalty. Firm has to embrace ren, yi, and li as the primary business goal. In fact, they are not the means but the end in themselves. The continuous pursuit of these cardinal virtues at the firm level not only establishes proper corporate values but also enables a firm to act morally in the course of business. Such kind of firm is known as junzi corporation. (shrink)

Ethical leadership has so far mainly been featured in the organizational behavior domain and, as such, treated as an intra-organizational phenomenon. The present study seeks to highlight the relevance of ethical leadership for extra-organizational phenomena by combining the organizational behavior perspective on ethical leadership with a classical marketing approach. In particular, we demonstrate that customers may use perceived ethical leadership cues as additional reference points when forming purchasing intentions. In two experimental studies, we find that ethical leadership positively affects purchasing (...) intentions because of customers’ concerns for moral self-congruence. We show this by means of both mediation and moderation analyses. Interestingly, the effect of perceived ethical leadership on purchasing intentions holds over and above the ethical advertising claims that are commonly used in marketing. We conclude by discussing the possible ramifications of ethical leadership beyond its effects on immediate employees. (shrink)

The economic costs to the insurers of complementary routine genetic testing would outweigh the benefits. However, should testing technology in future be refined so as to produce a cheap and reliable test, there is no reason why insurers might not take up predictive testing as part of the normal underwriting process. It is this possibility which justifies formulating a pre-emptive policy. At the very least, there are reasons for promoting and protecting the welfare of the proposer so as to redress (...) the bargaining positions between him or her as a consumer of a service and the insurer as a commercial concern. Further considerations relate to the social purpose of insurance as a social mechanism, and the need to find ways of avoiding undermining this in light of Human Genome Project. (shrink)

In The Ethics of Universal Health Insurance, Alex Rajczi shows how defenders of universal health insurance can address the ethical issues raised by these objections and make the moral case for an American universal health insurance system that improves on the gains made in the Affordable Care Act.

Background Issues of the aging population and disability of older persons have been rapidly developing in China over the past 20 years. Since 2016, the Chinese government has been exploring remedies to alleviate social and family burdens and ensure the dignity of the disabled old persons by implementing long-term care insurance systems in a few pilot cities across the country. Purpose The purpose of this study is to present the current challenges faced by China’s long-term care insurance system (...) and put forth suggestions for the future, based on literature research and the feedback obtained from its implementation in pilot areas. Research Design This paper conducts a theoretical study based on the principles of public health ethics. Study Sample Since 2016, China has launched two batches of pilot cities for long-term care insurance. The analysis object of this study is the feedback on the policy implementation of the existing 29 pilot cities that participated. The relevant data involved in the analysis are from the authors' field research and published literature on the analysis of pilot cities. Analysis The ethical value and importance of long-term care insurance policies in China are evaluated from the perspectives of policy philosophy and social individual interests. Results The results of this evaluation show that the core ethical values were not met in the development of China’s current long-term care insurance system. Moreover, distributive justice norms were neglected, and access to the system between different social groups and within the groups covered by it was unequal. Conclusions This paper argues that long-term care insurance should not differentiate between urban and rural areas in allocating nursing resources. Additionally, it would be essential to build democratic supervision and manage public opinions by adopting open and transparent information-sharing policies. Standards of disability assessments and treatment payment should be at par to ensure a balance between the rights and obligations of policyholders. (shrink)

Step therapy is an insurance company policy whereby patients must try a less costly treatment and fail-first before the insurer will cover another, more costly treatment. This article argues that there are relevant and well-established principles of medical ethics—the duty to practice evidenced-based medicine and the duty to consider cost-effectiveness when treating patients—that constrain and guide physician behavior with respect to step therapy; clinical practice guidelines promulgated by authoritative physician groups attempt to incorporate and reconcile the competing demands (...) of evidenced-based and cost-effective medicine, although it is unclear whether they do so in a manner that appropriately considers all relevant ethical factors relating to cost-effectiveness; and despite the potential shortcomings of CPGs, the ethical principles guiding and constraining physician behavior can help demarcate the ethical boundaries for other actors in the drug prescribing and reimbursement matrix, including insurance companies and benefit managers. (shrink)

In the current socioeconomic environment, brands increasingly need to portray societal and ethical commitments at a corporate level, in order to remain competitive and improve their reputation. However, studies that relate business ethics to corporate brands are either purely conceptual or have been empirically conducted in relation to the field of products/goods. This is surprising because corporate brands are even more relevant in the services sector, due to the different nature of services, and the subsequent need to provide a (...) consistent high-quality customer experience across all the brand–customer interactions and touch-points. Thus, the purpose of this article is to study, at a corporate brand level and in the field of services, the effect of customer perceived ethicality of a brand on brand equity. The model is tested by structural equations, using data collected for eight service categories by means of a panel composed of 2179 customers. The test of measurement equivalence between these categories is conducted using generalizability theory. Confirmatory factor analysis marker technique is applied in order to check for common method variance. The results of the hypothesized model indicate that customer perceived ethicality has a positive, indirect impact on brand equity, through the mediators of brand affect and perceived quality. However, there is no empirical evidence for a direct effect of customer perceived ethicality on brand equity. (shrink)

In order to be competitive in an era of ethical consumerism, brands are facing an ever-increasing pressure to integrate ethical values into their identities and to display their ethical commitment at a corporate level. Nevertheless, studies that relate business ethics to corporate brands are either theoretical or have predominantly been developed empirically in goods contexts. This is surprising, because corporate brands are more relevant in services settings, given the nature of services, and the fact that services settings comprise a (...) greater number of customer–brand interactions and touch points than goods contexts. Accordingly, the purpose of this article is to empirically examine the effects of customer perceived ethicality of corporate brands that operate in the services sector. Based on data collected for eight service categories using a panel of 2179 customers, the hypothesized structural model is tested using path analysis. The generalizability theory is applied to test for measurement equivalence between these categories. The results of the hypothesized model show that, in addition to a direct impact, customer perceived ethicality has a positive and indirect impact on brand equity, through the mediators of recognition benefits and brand image. Moreover, brand heritage negatively influences the impact of customer perceived ethicality on brand image. The main implication is that managers need to be aware of the need to reinforce brand image and recognition benefits, as this can facilitate the translation of customer perceived ethicality into brand equity. (shrink)

COLI – company owned life insurance – is often purchased by firms on employees in whom the firm has no demonstrable insurable interest. Though no immediate harm comes to individuals insured in this way, purchasing such policies raises moral questions. From a Kantian framework, questions arise about reciprocity and fairness, the deception of employees, the generation of mistrust, and the use of the employee’s life as a means to profit. No compensating social good is served by the sale of (...) these policies. (shrink)

This paper focuses much-needed attention on the ethical nature of customer relationship management (CRM) strategies in organisations. The research uses an in-depth case study to reflect on the design, implementation and use of ‘best practice’ associated with CRM. We argue that conventional CRM philosophy is based on a fairly narrow construct that fails to consider ethical issues appropriately. We highlight why ethical considerations are important when organisations use CRM and how a more holistic approach incorporating some of Alasdair MacIntyre's (...) ideas on virtue ethics could be relevant. (shrink)

This research seeks to better understand how an organization-related employee perception and job attitude may influence organizational members to ethically create customer value. Specifically, it is proposed that high person–organization fit perception, more precisely ethical values person–organization fit perception, can influence business-to-business salesperson commitment to providing superior customer value both directly and indirectly through trust in sales manager, while encouraging ethical salesforce behavior, an important aspect of communicating and delivering customer value. Results from a study of 408 (...) business-to-business salespeople find that ethical values person–organization fit positively influences salesperson commitment to providing superior customer value, as well as trust in manager. Trust in manager directly affects commitment to customer value and mediates the relationship between ethical values person–organization fit and unethical intent. Theoretical and managerial implications are provided, as well as directions for future research. (shrink)

Tort law and liability insurance have a complex interaction in which each shapes the evolution and effects of the other. This interaction and its many forms and facets in different international contexts must be comprehended to understand fully the ethical responsibilities of liability insurers. This essay builds on previous scholarship on the tort law–liability insurance interaction through a series of observations from the perspective of a global reinsurer. It seeks in part to extend previous analyses of this interaction (...) by also considering issues in the developing world. It seeks to make some normative questions and stances explicit concerning this interaction, as well as to identify some empirical questions that still need to be answered. The responsibility of liability insurers includes ethically shaping the responsibility of others in interaction with tort law in countless diverse situations. (shrink)

Incivility among employees in frontline encounters is prevalent, but little is known about its impact on customers’ ethics-related perceptions and behaviors. Drawing upon the stimulus–organism–response paradigm, this study examines how witnessing incivility among employees can serve as a social atmospheric cue to influence customers’ perceived ethicality of an organization and their subsequent behaviors. According to our results, in response to employee-to-employee incivility witnessed during frontline encounters, customers perceive the uncivil employees’ organization to have a lower level of ethicality. In (...) turn, customers engage more in unethical behavior and less in customer citizenship behavior. We further demonstrate that the negative effect of uncivil employee-to-employee interactions on customers’ perception of the ethicality of an organization is amplified when customers have an a priori perception that the organization is competent. The findings hold theoretical and practical implications for the management of employee-to-employee incivility and unethical customer behavior during frontline encounters. (shrink)

Culinary traditions and food practices are at the center of our daily lives and therefore constitute an important part of culture. Whether they are part of significant rituals or simply routinely enacted, they tell us something about the way we relate to each other and to the non-human world. In other words, food practices have an ethical dimension. Our paper focuses on the possibility to make objective ethical assessments of problematic cultural practices rooted in culinary traditions as a reply to (...) arguments associated with an ethical relativism according to which cultures produce ethical systems that are self-validating and therefore that cannot be criticized objectively. Drawing from examples involving animal cruelty and production methods harmful to the environment, we argue that it is possible to judge ethically questionable food practices from an objectivist standpoint inspired by moral progress, in contrario to a relativist point of view. Following a short discussion of ethical relativism, we present the outline of an acceptability test for questionable food practices and use it to analyse the case of the dog meat industry in South Korea. (shrink)

It was proposed that ethical evaluation of insurance claim padding behavior would be affected by characteristics of the policyholder, insurance agent, and company. These three factors were manipulated in written scenarios and the premise was tested in a factorial experimental design. No significant support was found for an effect of any of the three factors on ethical perceptions of claim padding. However, females found claims padding to be significantly less ethical than males. Given a claim scenario where the (...) actual loss was $500 and the claimed amount was $3000, subjects awarded an average of $986.91 on the claim. Many respondents were willing to compensate victims for intangible losses as well as tangible losses. (shrink)

Decisions based on ethics confront nurses daily. In this account, a cardiac nurse struggles with the challenge of securing health care benefits for Justin, a patient within the American system of health care. An exercise therapy that is important for his well-being is denied. The patient’s nurse and an interested insurance agent develop a working relationship, resulting in a relational narrative based on Justin’s care. Gadow’s concept of a relational narrative and Keller’s concept of a relational autonomy guide (...) this particular case. As an ethics framework influenced by feminist ethical theory, Gadow’s, Keller’s and Tisdale’s ideas demonstrate the fluidity with which the nurse and others can work while maintaining both autonomy and engagement without being self-sacrificing. (shrink)

Customer orientation and the development of long-term relationships with customers are known conditions for growth and profit sustainability. Businesses use special treatments, inducements, and personal gestures to show their appreciation to customers. However, there are concerns about whether these inducements really create the right perceptions in customer’s mind. This study suggests that when customers believe that the firm is ethical, the inducements and special treatments received are seen in a positive light and can help develop loyalty. The hypotheses (...) were tested with responses from 299 customers of financial institutions in Chile. Results support the hypotheses that firm’s ethical reputation helps in retaining customers. Managerial implications are provided. (shrink)

In the current era of the Sustainable Development Goals, many countries are attempting to strengthen their health system and achieving Universal Health Coverage. The Korean National Health Insurance system functions as a core element of health financing, contributing to achieving UHC by promoting public health and social security through insurance benefits for prevention, diagnosis, treatment, rehabilitation, childbirth, and health promotion. The Republic of Korea achieved 100% NHI coverage of the target population in 1989, 12 years after the introduction (...) of the social insurance system. However, poor coverage of health services and lack of financial protection are major obstacles to achieving UHC. Therefore, the Korean government announced and implemented ‘Moon Jae-in Care’ in August 2017 to enhance the coverage rate of NHI by 70%. First, this study reviews the existing health insurance system in Korea from the perspective of health financing and UHC. Second, it analyses ‘Moon Jae-in Care’, based on the main framework of UHC. Third, it considers the ethical implications of these developments, with focus on the principles of equity, fairness, autonomy, and solidarity. Although the NHI reform is expected to propel Korean health care closer to UHC, many ethical, social, and political issues remain. (shrink)

There is a long-standing discussion on the positive interactions between enterprise value creation and business competitiveness. The corporate value can be seen as being created from three major sources within the cycle - from employees, from processes, and from customers or investors through reinvestment. To achieve competitive advantages, a firm must create more value than its competitors in the industry. Emphasizing that, firms should explore the positive drivers of customer value creation, allowing for a true value creation that will (...) lead to increments in competitiveness. In reality, however, there are also barriers that hinder customer value creation. Targeting the above issues that have not yet been explored or analyzed, we have collected related literature at the first stage. Based on these presumable assumptions, this paper then conducts an empirical study by surveying and analyzing the relevance given by the investigated leading machinery measuring equipment firms in Taiwan, regarding the concerns as drivers and barriers in relation to customer value creation. This paper expecially aims to answer several key questions: What drivers revolving around employees and processes can facilitate the organization to create more value for its customers? Conversely, what barriers block the organization from creating value for customers in examining the same dimensions? Does value creation direct an organization's profitability and competitiveness? Our questionnaire survey results show that the most recognized and agreed drivers of customer value creation in consideration of employees are "distinctive skills", "personal experience", "learning and training", and "team work"; and, in regard to the firm's processes, the key drivers are "innovation and evolution", "R&D capability", and "capability for differentiation". Conversely, the most recognized and agreed barriers to customer value creation in relation to employees are a "distrustful environment" and "inadequate knowledge"; and, in terms of processes, they are "short of core technology", "poor resource support", and "bad services and attitudes". Furthermore, our in-depth interview outcomes reveal that "capital sufficiency" and "mergers and acquisitions" are in practice considered to be other important customer value creation drivers; in contrast, "cultural and structural barriers" and "short of mechanisms to measure customer value creation effectively" are viewed as additional critical barriers to customer value creation. (shrink)

Life insurance settlements, or life settlements, are life insurance policies owned by investor-beneficiaries on the lives of unrelated individuals. With life settlements, investors make substantial payments to the insured individuals upon purchasing such policies, pay any remaining premius, and collect the death benefits upon the demise of the insured individuals. Transactions involving life settlements seem poised to become a major source of profits for investment banks, comparable in dollar amount to subprime mortgages. With life settlements, the insured individuals (...) suffer no immediate harm, and the sale of a policy an individual owns is permissible under current law. Nevertheless, moral questions can be posed about the social values expressed by these practices, the effect of these practices on the virtue of charity, and the overall loss of social utility that will result from life settlements. We consider life settlements from utilitarian and libertarian perspectives, and then consider the effects of life settlements on social values and on individual character. On balance, we favor legislative changes in insurance and tax laws to discourage life settlements, and argue that certain forms of life settlements should be banned outright. (shrink)